HFA Congress 2026 — Dr David Žižek (University Medical Centre Ljubljana, Ljubljana, SI) joins us to discuss findings from CONDUCT-AF, a randomised, multicentre trial comparing conduction system pacing (CSP) with biventricular (BiV) pacing following atrioventricular node ablation (AVNA) in heart failure patients with symptomatic atrial fibrillation and narrow QRS.

The trial enrolled 82 patients with LVEF <50%, narrow intrinsic QRS ≤120 ms, and AF refractory to drug therapy or catheter ablation across 10 European sites, randomising 1:1 to BiV pacing plus AVNA or CSP plus AVNA — with left bundle branch pacing (LBBP) as the preferred CSP technique. The primary endpoint was change in left ventricular ejection fraction at six months, with long-term follow-up of at least 24 months assessing heart failure hospitalisation, cardiovascular mortality, and pacing parameters.

Interview Questions:

1. What is the clinical rationale for evaluating conduction system pacing as an alternative to biventricular pacing in the context of AV node ablation, and what gap does CONDUCT-AF address?
2. Can you walk us through the trial design — how were patients selected, why was left bundle branch pacing the preferred CSP technique, and how was the comparison structured?
3. What were your key findings?
4. How did the two strategies compare on longer-term outcomes including heart failure hospitalisation and cardiovascular mortality?
5. How do these results inform the optimal pacing strategy for heart failure patients with AF and narrow QRS undergoing AV node ablation, and what should future trials address?

Recorded on-site at Heart Failure Association Congress 2026, Barcelona.
Editors: Jordan Rance
Videographer: Oliver Miles
Support: This is an independent interview produced by Radcliffe Cardiology.